Subsurface drip irrigation (SDI) has attracted an increasing interest in Spain in the last years due to its low operating pressure and lower energy cost that, coupled to other potential advantages, can make it more profitable than other irrigation systems (sprinkler systems in particular). This work reviews the main benefits and constraints of SDI, with special emphasis on design, management and maintenance problems, as well as on the potential salinization of surface soils in arid and semiarid areas irrigated with low quality waters. Well designed, operated and maintained SDI systems have shown to be profitable and sustainable. Nevertheless, SDI has drawbacks in relation to certain irrigation water, soil and crop characteristics that can jeopardize its sustainability and profitability. Therefore, the advantages and limitations of SDI must be evaluated on a case-by-case basis with the objective of providing solid recommendations to farmers.